Manual and manipulative therapy in addition to rehabilitation for osteoarthritis of the knee: assessor-blind randomized pilot trial.
From the Journal of Manipulative Physiologic Therapeutics. (2015 Jan;38(1):1-21.e2. doi: 10.1016/j.jmpt.2014.10.002. Epub 2014 Nov 20.)
Eighty-three patients were randomly allocated to 1 of the 3 groups (27, 28, and 28, respectively). Despite 5 dropouts, the data from 78 participants were available for analysis with 10% of scores missing. A minimum of 462 patients is required for a confirmatory 3-arm trial including the respective interventions, accounting for cluster effects and a 20% dropout rate. Statistically significant and clinically meaningful changes in scores from baseline to week 5 were found for all groups for the Western Ontario and McMasters Osteoarthritis Index (P ≤ .008), with a greater change in scores for MMT and MMT plus rehabilitation. Between-group comparison did not reveal statistically significant differences between group scores at week 5 for any of the outcome measures (P ≥ .46).
This pilot trial suggests that a confirmatory trial is feasible. There were significant changes in scores from baseline to week 5 across all groups, suggesting that all 3 treatment approaches may be of benefit to patients with mild-to-moderate knee OA, justifying a confirmatory trial to compare these interventions.
In English, please:
Patients had a decrease in pain and increase in function for those who added manipulation (“adjustments”) to their rehab program. More research should be done with more people to find out how much change.
Your chiropractor can help you change poor biomechanics and offer advice regarding exercise and nutritional support for arthritic joints.